Permit CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00334
41,11- Ali I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/12/2005
PARCEL: 2S109DA -10900
SITE ADDRESS: 12920 SW PINE VIEW ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 098 JURISDICTION: TIG
Project Description: All encompassing low voltage.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA /TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE COMMUNITIES, LLC GENESIS HOME TECHNOLOGIES
4230 GALEWOOD ST #100 9450 SW GEMINI DR
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008
Phone: 503 387 - 7538 Phone: 503 643 - 1704
Reg #: LIC 128098
ELE 26- 989CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/11/200E $75.00
[TAX] 8% State Surchart 10/11/200E $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 -0 -0 00. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
-
Issued By: X,t) Permittee Signature: _ ,.0211 ' /` P , _ _
•
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 503- 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Oct 11 2005 1:27PM GENESIS HOME TECHNOLOGIES 5036433300 p.1
Electrical Permit Appli 1 (11: (►1 t i t ► 1,1 1).1 \
City of Tigard ; )(' 1 1 11 2005 D I►r If /C) P No / , r _00 3_ q'
13125 SW Hall Blvd., Tigard, OR 97223 1. 00,1 _ Plea Review Other Permit: ' I
Phone: 503.639.4171 Fax: 503.598.196�1 � ' 1 Date/lsv:
Inspection line: 503.639.4175 r OF r i G A .: .. Dams Ready/Ey, ®8w Pane 2 for '
Werner www.citigard.M.us BtJf p N (� R . Nodfied/Matbed: / Sapphaheatel retormatlon
;�F
F'' ] -, S ; r 1, '-' a 4r t 1 1 Y u '- ', , i 3 1 . .4 � . . ,7._ f • K� o ,• ∎, att..r.. A.,:,. 1 '.‘--,.,`.,.
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1Si„ �Yrt _, e. Y t t� �� i � .. t b� I c W ,-"'""•!. �.x., r. �. ......
■ i 1 New construction ❑ Addition /alteration/replacement Please cheek all that apply:
❑ Deaiobthon ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑service over 320 amps - rating ['Bulldog over 10,000 sq. ft..
1 1' p F.' f `�� ' iF 1 1y JTpY� 7),G 'SNr�f�M�fY 14 1.{�W� i F� ANn 'r !1 ,{��y, rx l J t ` � W' t
� � 4 �"3t k N lvq n . „, u , ' < n 'ai r,,.., ,„r :,,
40;,et }.-
,140,aa• `•1�1.i1,4, P17 1114 . .41t1220% 4.t ' ? + 4 t? � ik 1 � D —1140 '. :� i of l and 2-family dwellings 4 or more new residential
1
R �I � �' t .�rl, s.y.��
1.1 1• end 2- family dwelling 171 Commercial/industrlal ❑ Accessory building ❑ System over 600 volts nominal units in one structure
El Mtilti•fanul El Master builder ❑Other ❑Building over three stories ❑Feeders. 400 amps or more
❑Occupant load over 99 persons ❑Maautgctured structures or
,'.! lin. u 1 wh,,aJ 1 - 1 Tri 1, ,i', l'i' t i i, 1 ' , .Y � ' r ' ' s rlf1 :''l ❑ d y � +g lr park
ark
trul,,rj c b:'.,r.ei.:.175 Itil ; ■ 1,7',,Sv4,,! �iahLtl ta ia l 3 Inn ;j �; ^ '+_'t s w . !?r r1 � . la ' J1 ra � ,� y, i 3:r 'i E as- affil
Job no.: Job sitm address: ❑Health -eats facility ❑fir: -
Submit a sets of plans with any of t above.
City /State/ZIP' s 0 _ The above are not applicable to temporary convection service.
sy al � l ;�np- gr`14, t3'«!pp!������&r(yjr.' X " . '' °N+ v 1 7 "' t t 7 Sa', : i 1 �, , •�Rtr 7 f�' 7 S(+j ?�ara. �°' c °' 'L??
Suite/bldg. /apt, nu.: Project name:
,� ,.. 11h IN V,.i!IIVJGQ iY ii: t i MGw via. .u, +.ri:7' I A .` }{IYAIff �h � r`IY. ^...t '
bese,ipclm Qtr, z Total �•
Cross street/directions to Job site: New residential single- or multi - family dwelling snit.
Includes attached garage.
1,000 sq. ft or less 145.15 4
Subdivision: , Lot no.: q - Ea. add'l 500 sq. f1, or portion 33.40 1
!.baited energy, residential ) 75.00 /6 2
Tax map /parcel no Limited energy, non- resldentiel 75.00 2
t �'d '�* x?ji x i I.tP .{i��r�a�w t Yi t m� • w K i ;n e�� "r+ i. M.h 1 `tt'f F � t7�, 3'r R n� I {. i n���ty'�>I,rwl� 4
rile, :u:sae'. 6 ,n;S, r,S,.011, ikfi,1�?2r.zi:iiude a `:i f- 5t {�'t�:t1�mT:t,st nt � 7�1,4'1.V �:, r t^,i9 i.:0.S i 411el �. t•
Each m,ufacblred or modular
dwelling, service and/or feeder 90.90 2
a I . • i. i/ : i Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
J >�1 T ; • ,µµ »',. ..x{ + , . la N � i �p,, i ,��1 � y{ ,1 a� r '' ���y�yy , y•• tt; � : � „� ' ,,a 371,1; , n, r i r r } �� 201 a00ps be 400 amps 106.85 2
4.4 5,E +I,.,,,J.,C rev t„. ...d ;tt 4.f.7.bti 'S *);�Ni „; eLA i1Y'tt �r ":� t PO!M. ,1 N..
401 amp to 600 amps 160.60 2
Name: .. I C _���� 601 amps to 1.000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: 10./.42... A_ Temporary services or feeders Installation, alteration, and/or
relocation
Phone: (9'0j) i 7 , Fax: ( ) 200 amps or less 66.85 1
Owner last.allations This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent. or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuit. - new, alteration. or extension, per panel
� r S y � , a c t e^ w w, v z ? f { p x / y ., ,
f� {tiP.,c2 S g? el....iv ! „ i•9r iA + °S ryi, , p y t y {! �L N 1 1 cim : dkl,,,,f lust: .Y ,, y, I. n S + 1 p C , 4 w `� A. Fee for branch circuits with
u , '�: � ., ) t. ,..wa,',11 ;ova.- N.,,, " .. � �j& 21.6 4,,p i,ta, 1t..4! e%,w:t a 4.git : n, �s4.. :1 X
3,tr.wi, ri,w'�+ s.... �.,��. .,x r .,i 1 ' -w ' service ortbederfee, each
Business name: bran circuit 6.65 2
branch
B. Pee for branch circuits
Contact name: wahoul service or feeder fee,
each branch circuit �' 2
Address: Each edd'l branch circuit 6.65 _ 2
City/State/ZIP: Miscellaneous (service or feeder not faciuded)
Phone: ( ) Fax:: ( ) pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-mail; Signal circuit(s) or limited -
v:s ., e r R t y f M u7 n f` `1'nn:r u tt } alr.n + , ,� , . I, r i x1 r +n �# 'f «porgy panel, al
, �,'� @��Y:�i? M.��;l�; � i 7aE �«'� "lv �' �,� � a � ; ,y, v E ► t t , f f � � a. � alteration or
r ! r. c� 41,. Eb"..9, ,i.t i 4 c. a. <:,t.n,tn;. n.s.t„�6Wra,. 7�+tll,J i �aa r.�,I Pldt.. i # : :A l S9 S t�u2 n' u_> >< fi extension. Describe: Pege2 2
Business name:
Earls additional inspection over allowable In any of the above
Per inspection 62.50
Cit GENESIS HOME TECHNOLOGIES Investigation per hour (1 la min) 62.50
p>u 9450 SW Gemini Drive Beaverton, OR 97008 Industrial plant per llour 73.75
Ph 50 - 643 - 1704 Fax. 503 - 643.3300 ",r. nh�c�`t�'l1
r (acxkr Cr., :r r IP 1 , +�' , ;,:4'
, ;� : :' 1 a ..i. ...�.,�« 5...,.o�s ` J� a rte'
]:a'_1�tY t:'ryl ,.`e +, 'i .
Cc CCB 128098, CLE26 -988, Subtotal 75- 0 mo o ,
Sul 28e5 - JLE Plan review (25% of permit fee)
Print name: G i , . Date: WM. State surcharge (8% of permit fee) o 0 Is
- TOTAL PERMIT FEE ii t Ob
Authorized signature: This permit application expires if* permit Is not o►tataed wlfkln 150
drys after it has been accepted u complete
Print name: Date: ■ Pee methodcloyy set by Tri -County Bpildio6 Industry 5arvia. Board
” Number of inspections per penuit allowed_
1141. P . ai2LC eceicAppdec 14!01 440.46IST(id arco IWBn
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005-00334
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/12/2005 _a►
Phone: (503) 639 -4171 r a'�NN °BPiNlfll��'` �\
Inspection Requests (24 Hrs.): (503) 639 -4175 'IL.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 79
w
. - NMI, I
SITE ADDRESS: 12920 SW PINE VIEW ST CLASS OF WORK: 1
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 098 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: All encompassing lowlroltage. u
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OWNER: DON MORISSETTE COMMUNITIES, LLC, PHONE #: 503. 307 -7538
CONTRACTOR: GENESIS HOME TECHNOLOGIES to PHONE #: 503 -643 -1704
Inspection Request Scheduled For: Date: 10/31/200r Pour Time:
Code # Inspection Description Confirm # o ntact # Message
135 Low voltage • 019744 - 01 503613 N
Corrections /Comments/ Instructions:
:z__________
/A;i
I
ASS ❑ PAR IAL APP '0 • L ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ • LL Fr NS' ' CTION ADDITIONAL FEE ASSESSED
. //I / ..� �'
Inspector: Dat� �
DM/ Phone #: (503) 718-
r
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